International journal of public health · 2025
Treatment-Seeking for Children with Suspected Severe Malaria Attending Community Health Workers and Primary Health Centres in Adamawa State, Nigeria.
СтатьяНазвание и аннотация: Перевод в очереди
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Lee Tristan T, Omoluabi Elizabeth, Ayodeji Kazeem, Yusuf Ocheche, Okon Charles, Brunner Nina C, Delvento Giulia, Signorell Aita, Lambiris Mark J, Kwiatkowski Marek, Burri Christian, Lengeler Christian, Emedo Emmanuel, Cheshi Fatima, Fashanu Chizoba, Wiwa Owens, Hetzel Manuel W
Аннотация
OBJECTIVES: In the context of introducing pre-referral rectal artesunate for children with severe malaria in Adamawa State, Nigeria, case fatality was 19% among severely sick children visiting primary health centres (PHCs), and 6% among those visiting community health workers (CORPs). To understand this difference, we investigated illness severity, treatment-seeking, and background characteristics of these patients.
METHODS: 589 children <5 years of age with fever and danger signs indicative of severe malaria attending CORPs (N = 314) and PHCs (N = 275) were enrolled. After 28 days, caregivers were interviewed about background characteristics, symptom severity, and treatment seeking practices; children attending CORPs and PHCs were compared.
RESULTS: Compared to children attending CORPs, those attending PHCs were more likely to live in urban areas, have ≥4 clinical danger signs (50% vs. 39%, p = 0.02) and signs of central nervous system involvement (90% vs. 74%, p < 0.01), and more often received initial home treatment (42% vs. 33%, p = 0.04).
CONCLUSION: PHCs may see sicker children due to community assumptions of their professional capacity. Health system strengthening is required to capacitate PHCs to handle severe conditions and save lives in rural communities.
METHODS: 589 children <5 years of age with fever and danger signs indicative of severe malaria attending CORPs (N = 314) and PHCs (N = 275) were enrolled. After 28 days, caregivers were interviewed about background characteristics, symptom severity, and treatment seeking practices; children attending CORPs and PHCs were compared.
RESULTS: Compared to children attending CORPs, those attending PHCs were more likely to live in urban areas, have ≥4 clinical danger signs (50% vs. 39%, p = 0.02) and signs of central nervous system involvement (90% vs. 74%, p < 0.01), and more often received initial home treatment (42% vs. 33%, p = 0.04).
CONCLUSION: PHCs may see sicker children due to community assumptions of their professional capacity. Health system strengthening is required to capacitate PHCs to handle severe conditions and save lives in rural communities.